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Acute and long-term outcomes of ostial stentings among bare-metal stents, sirolimus-eluting stents, and paclitaxel-eluting stents

Hsieh, I-Changa; Hsieh, Ming-Jera,b; Chang, Shang-Hunga; Wang, Chao-Yunga; Lee, Cheng-Hunga; Lin, Fen-Chiunga; Chen, Chun-Chia

Coronary Artery Disease:
doi: 10.1097/MCA.0b013e32835c8fce
Therapy and Prevention
Abstract

Objective: The aim of this study is to evaluate the acute and long-term outcomes of ostial stentings among bare-metal stents (BMS), sirolimus-eluting stents, and paclitaxel-eluting stents.

Materials and methods: According to the CAPTAIN (Cardiovascular Atherosclerosis and Percutaneous TrAnsluminal INterventions) registry, from November 1995 to June 2011, 420 patients with ostial lesions were treated using BMS implantations (243 patients with 247 lesions), CYPHER implantations (77 patients with 77 lesions), or TAXUS implantations (100 patients with 104 lesions).

Result: Compared with the CYPHER and TAXUS groups, the BMS group had larger late loss (0.29±0.53, 0.64±0.78, and 1.30±0.79 mm, respectively, P=0.006) and restenosis rate (6, 8, and 33%, respectively, P<0.001). During the long-term follow-up, the BMS group had higher target lesion revascularization than the CYPHER and TAXUS groups (17, 4, and 6%, respectively, P=0.002). The cardiac event-free survival rate, as determined by the Kaplan–Meier analysis, was also lower in the BMS group than in the CYPHER and TAXUS groups (55, 86, and 76%, respectively, P<0.001).

Conclusion: Intracoronary stenting with drug-eluting stent for ostial lesions was associated with lower angiographic restenosis and late loss, and a more favorable long-term clinical outcome than BMS.

Author Information

aSecond Section of Cardiology, Chang Gung Memorial Hospital

bGraduate Institute of Clinical Medicine, Chang Gung University, Taoyuan, Taiwan

Correspondence to Chun-Chi Chen, MD, Chang Gung Memorial Hospital, No 5 Fushing 1st Road, Taoyuan 333, Taiwan Tel: +886 3 3281200 x8115; fax: +886 3 3289134; e-mail: mjhptcastent@gmail.com

Received October 1, 2012

Accepted November 11, 2012

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins